New Student Financial Aid Information Form

This application is required for all students applying for or receiving scholarships and/or other financial aid at Augustana College. Students who wish to be considered for state, federal or institutional funds including grants, federal work programs and/or student and parent loans must also complete the 2021-22 Free Application for Federal Student Aid (FAFSA). The FAFSA may be completed electronically by visiting www.fafsa.gov after October 1, 2020.

New Student Information 2021-22

First Name

Middle Name

Last Name

Email Address

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Will you complete the 2021-22 Free Application for Federal Student Aid (FAFSA)?

Yes

No

Social Security Number is required (please include dashes ex. ###-##-####)

Where will you be living during the academic year?

Campus housing

With parents

Off-campus apartment

I own my own home

Are you the beneficiary of a 529 pre-paid tuition plan?

Yes

No

If yes, check one:

College Illinois (pre-paid tuition plan)

Other pre-paid college tuition plan

Enter name of other pre-paid college tuition plan

Students are sometimes eligible for awards on the basis of ethnicity, religion or major. Providing the following information is optional.

Religious denomination

Name of congregation

City and State of congregation

Ethnic background

Are you of Swedish heritage?

YES

NO

Vocational interest

In addition to grants, for what type(s) of aid/scholarships will you be applying? Check all that apply.

Art, music and theatre scholarships require auditions with departments. Visit www.augustana.edu/scholarships for audition dates, applications and application deadlines. If applying for art, music or theatre scholarships:

I have scheduled an audition with the department.

I will contact the department to schedule by the appropriate deadline(s).

Visit our Scholarship Website to fill out the appropriate forms for Fine Arts Scholarships ( Music, Theatre and Art).

Will you receive veterans’ education benefits (as a veteran or by transfer of benefits) during the 2021-22 academic year?

Yes

No

What chapter and branch of service will provide benefits?

Chapter:

Branch of service:

Were you born before January 1, 1998, or otherwise is determined to be independent for financial aid purposes (see FAFSA guidelines)?

Yes

No

Parental Information

This section should be completed by the legal parent(s) with whom the student resides. (“Legal parent” is defined as biological or adoptive parent.) If the student lives in a single-parent household, only the information about that parent should be reported. However, if a divorced or widowed parent has remarried, information about the stepparent is required. If a student’s legal parents are not married but are living together, information about both parents is required.

Parent 1

Check one:

Biological/adoptive parent

Stepparent

Other

Full Name

Work or cell number:

Email address:

Occupation:

Employer:

Self Employed

Unemployed

If unemployed, date of last employment:

Parent 2

Check one:

Biological/adoptive parent

Stepparent

Other

Full Name

Work or cell number:

Email address:

Occupation:

Employer:

Self Employed

Unemployed

If unemployed, date of last employment:

Are your biological/adoptive parents divorced or separated?

Yes

No

If divorced or separated: To be answered by the parent who completes this form about the non-custodial parent, if the student’s legal parents (biological or adoptive) are divorced, separated or remarried.

Year of separation:

Year of divorce:

Non-custodial parent's full name:

Home address:

How much does the non-custodial parent plan to contribute to the student’s education for the 2021-22 school year?

Financial aid awards and billing documents may be provided and discussed with non-custodial parent listed above?

Yes

No

Augustana College's Office of Financial Aid does not make a student's financial aid awards and billing information available to a non-custodial parent unless authorized to do so in writing by the custodial parent and student. This form can be printed and emailed to financialaid@augustana.edu or mailed to:
Augustana College
Office of Financial Aid
639 38th St.
Rock Island, IL 61201

Families occasionally have unusual expenses/circumstances beyond their control. Unusual expenses such as high medical or dental expenses, substantial reduction in parent income since the 2019 tax year, parent in college, childcare or other special circumstances in some instances can be considered when determining financial aid. However, the FAFSA must be filed for such circumstances to be considered. Additional forms also will be required to address these circumstances in more detail. Please attach a separate note should you have any unusual circumstances. (To determine whether you should complete a special circumstance form, call the Office of Financial Aid at 309-794-7207 to speak with your financial aid counselor.)

Unusual/Special Circumstances

Student Electronic Signature

I affirm, by signing electronically my name below, the information on this form is correct to the best of my knowledge and I will notify Augustana College if there is a change.

Student Signature

Date